<!DOCTYPE html>
<html>
<head>
<meta charset="utf-8">
<title>在线报案6-4</title>
<meta name="keywords" content="众安保险，互联网保险，网上支付，保单查询，在线理赔，让保险有温度" />
<meta name="description" content="众安保险是国内首家也是唯一一家互联网保险公司，个性化定制风险解决方案，全方位采用互联网先进科技，追求流畅、贴心、温暖的用户体验。" />
<!--统一加载公共js与css文件-->
<meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
<meta name="viewport" content="width=device-width,initial-scale=1.0,minimal-ui,maximum-scale=1.0,user-scalable=0" />
<meta http-equiv="X-UA-Compatible" content="IE=edge">
<meta name="apple-mobile-web-app-capable" content="yes">
<meta name="apple-mobile-web-app-status-bar-style" content="black">
<meta name="format-detection" content="telephone=no" />
<link rel="apple-touch-icon-precomposed" sizes="57x57" href="../../image/apple_icon/zhongan_icon_52.png" />  
<link rel="apple-touch-icon-precomposed" sizes="72x72" href="../../image/apple_icon/zhongan_icon_72.png" />  
<link rel="apple-touch-icon-precomposed" sizes="114x114" href="../../image/apple_icon/zhongan_icon_114.png" />    
<link rel="apple-touch-icon-precomposed" sizes="144x144" href="../../image/apple_icon/zhongan_icon_144.png" /> 
<link type="image/x-icon" rel="Shortcut Icon" href="../../image/apple_icon/zhongan_icon_144.png">
<link href="../../css/za-web-common.css" rel="stylesheet">
<script type="text/javascript" src="../../js/form/zepto.min.js"></script>
<script type="text/javascript" src="../../js/form/sea.js"></script>
<script type="text/javascript" src="../../js/web_common.js"></script>
</head>
<body>
<div class="activation-contain">
<input type="hidden" value="1" id="minPhoto" />
<form id="CM_Form" action="在线报案6-5.html" method="post" autocomplete="off">
  <div class="form-box">
    <div class="form-info-explain">
      <div class="info-title">
        理赔信息
      </div>
      <div class="form-list no_line ptb0 mtb15">
        <div class="form-list-left w90">
          被盗刷卡号
        </div>
        <div class="form-list-auto">
          123123123123132213
        </div>
      </div>
      <div class="form-list no_line ptb0 mtb15">
        <div class="form-list-left w90">
          开户银行
        </div>
        <div class="form-list-auto">
          123123123123132213
        </div>
      </div>
      <div class="form-list no_line ptb0 mtb15">
        <div class="form-list-left w90">
          挂失日期
        </div>
        <div class="form-list-auto">
          123123123123132213
        </div>
      </div>
      <div class="form-list no_line ptb0 mtb15">
        <div class="form-list-left w90">
          交易时间
        </div>
        <div class="form-list-auto">
          123123123123
        </div>
      </div>
      <div class="form-list ptb0 mtb15">
        <div class="form-list-left w90">
          交易金额
        </div>
        <div class="form-list-auto">
          789.00
        </div>
      </div>
    </div>
  </div>
  <div class="form-box">
    <div class="form-info-explain">
      <div class="info-title">
        图片资料
      </div>
      <div class="za_web_group_imgupload_img mt10" id="photoRoom" onclick="selectPhoto();">
          <div class="imgupload_img_cell imgupload_room">
            <img alt="" src="../../image/icon/icon_imgupload_bg.png">
          </div>
          <div class="clear"></div>
      </div>
      <div class="form-list no_line">
        <div class="form-list-auto gray">
          请拍照上传身份证正反面照片及签名<br/><span class="txt12">(在第三方交易平台盗刷需额外补充交易流水照片)</span>
        </div>
      </div>
    </div>
  </div>
  <div class="form-box">
    <div class="form-info-explain">
      <div class="info-title">
        警方报案回执
      </div>
      <div class="form-list no_line">
        <div class="form-list-auto gray">由于您的索赔金额高于3000元，您还需提供<span class="blue">警方报案回执</span>。请将回执邮寄至以下地址，我们会及时处理您的资料：<br/><span class="blue">上海市黄浦区圆明园路169号四楼<br/>众安保险理赔部</span>
        </div>
      </div>
    </div>
  </div>
  <div class="za-nobg-box plr10">
    <div class="zaw-btn-box">
      <div class="zaw-btn-box-room"><a href="javascript:void(0);" onclick="window.history.back()" class="zaw-btn">返回重填</a></div>
      <div class="zaw-btn-box-room"><a href="javascript:void(0);" id="zaw-btn" class="zaw-btn zaw-btn-blue-bg">确认提交</a></div>
    </div>
  </div>
</form>
</div>
<div class="move-contain" id="moveContain">
  <div class="form-box">
    <div class="form-info-explain">
      <div class="info-title no_line">
        请拍照上传
      </div>
      <div class="za_web_group_imgupload_img " maxlen="10" id="imgList1">
          <div class="imgupload_img_cell imgupload_room" id="upoladimg1">
            <img alt="" src="../../image/icon/icon_imgupload_bg.png">
          </div>
          <div class="clear"></div>
      </div>
    </div>
    <div class="form-list">
      <p class="clearfix gray">
        <span class="fl w50p">1,身份证正面</span><span class="fl w50p">2,身份证反面</span>
      </p>
      <p class="clearfix gray">
        <span class="fl w50p">3,本人签名</span><span class="fl w50p">4,交易流水</span>
      </p>
    </div>
  </div>
  <div class="za-nobg-box plr10">
    <div class="zaw-btn-box">
      <div class="zaw-btn-box-room"><a href="javascript:void(0);" id="zaw-btn-photo" class="zaw-btn zaw-btn-blue-bg">下一步</a></div>
    </div>
  </div>
</div>
<div style="display:none;">
  <form id="uploadForm">
    <input type="file" style="display: none" id="tyrePlusImg" name="fileData">
  </form>
</div>
<script type="text/javascript" src="../../js/html/report/report4.js"></script>
</body>
</html>